A weight-loss therapy that focuses on personal values and
"mindful" decision-making helps people shed more than 13 percent of
their initial weight, on average, a new clinical trial suggests.
To put that into perspective, current behavioral therapies typically help people drop 5 percent to 8 percent of their starting weight, the study authors said.
Researchers call the new approach acceptance-based behavioral therapy (ABT). The study authors said ABT addresses some of the biggest obstacles in keeping extra pounds off -- including the difficulty of resisting temptation.
There is nothing new about using behavioral therapy to help people lose weight. But, Forman said, the standard approaches don't address the main issue. "People are biologically driven to eat, especially foods that are rewarding and taste good," he said.
ABT aims to teach people skills to resist temptations. The new clinical trial put the approach to the test by comparing it with standard behavioral therapy, which only encourages reducing calories and increasing exercise.
Forman's team recruited 190 overweight or obese adults and randomly assigned them to either ABT or standard treatment. People in both groups went to 25 group sessions over one year, meeting with therapists with expertise in weight loss.
Both groups received help with diet changes and exercise, "problem solving," and dealing with food cravings. But ABT had added components.
People chose a goal based on their "personal values" -- rather than aiming for a certain number on the bathroom scale. A person might, for example, choose the goal of being a healthy, active grandmother.
During ABT, people learn to notice how "cues" from their environment -- from TV to the presence of tempting food to sheer boredom -- influence their decisions to eat.
In this new trial, the approach appeared to work better than standard therapy: After a year, ABT patients had lost a little over 13 percent of their starting weight, compared to just under 10 percent for people in the comparison group.
The ABT group also fared better when it came to keeping the pounds off: 64 percent had maintained at least a 10 percent weight loss at the one-year mark, compared with 49 percent of the standard-therapy group.
Dr. Steven Heymsfield is a spokesman for the Obesity Society and a professor at Pennington Biomedical Research Center, in Baton Rouge, La said, "It recognizes the underlying biological drive to eat, and provides people with a powerful counterweight to that."
Losing weight is not just about "willpower," Heymsfield said. People have to overcome strong biological impulses -- and that takes strong motivation, he said.
It makes sense that focusing on important personal values (such as being a healthy grandma) can work better than a "superficial goal" of fitting into smaller jeans, Heymsfield said.